Mister Germ Hygiene and Nutrition Program

North Coast Area Health Service



Enterprise and resourcefulness

The Mister Germ program utilises existing resources:

  • The NSW Mister Germ program modelled from the QLD Mister Germ primary school program.
  • The components incorporated into the NSW model came from existing resources, including existing health programs and health information.
  • The program is made sustainable as it utilises the staff within the preschools to carry out the program.
  • Once this program is set-up it is cost neutral.
  • The effectiveness of the Mister Germ model on the North Coast has resulted in the expansion of the program to other health services, states and other health programs.

Rationale for the program

The North Coast Area Health Service (NCAHS) recognises the importance of good hand washing practices as it has initiated through the Australian Commission on Safety & Quality in Health Care a national hand-washing project for 2007-2010.

Children between the ages of 0-5 are commonly associated with communicable diseases and are considered a high risk group. Young children, especially those in childcare, are particularly vulnerable to infection and diseases for several reasons: exposure to germs in group care, immature immune systems, behaviours that spread germs (thumb sucking, putting objects in their mouths), and lack of control of bodily fluids (Holland, 2008).

The Mister Germ Program

Information: Materials in this program provides the preschools of the North Coast specifically those that are isolated and limited access to up to date information on immunisation and childhood diseases. This is especially important due to the resent outbreaks in the North Coast of cryptosporidium, boils and whooping cough which have highlighted the importance of good hygiene practices among children.

A Nutrition component: Early childhood is a critical time in a child’s development when the foundations for good or poor eating habits and self-regulations of appetites are laid. The early childhood sector can make an important contribution in preventing childhood overweight and obesity. Healthy foods will improve the immune system of a child therefore their ability to fight disease.


The aim of the Mister Germ Program is to provide resources and train teachers to implement a sustainable hygiene and nutrition program in their pre-school that will lower the risk of disease transmission.


  • To provide an evidenced based teaching strategy to provide an interactive prevention program by using fun visual, verbal and physical education strategies.
  • To increase awareness of hand-washing and hygiene practices at the preschool and at home.
  • To provide information to teachers and parents on immunisation and communicable  diseases.
  • To increase awareness of healthy foods in the preschool.

Performance indicators

  • Evaluation of pilot program 2007.
  • Number of preschools that participate in the training.
  • Number of teachers trained.
  • Number of local government areas involved.
  • Number of preschools that introduce the program into their preschool.
  • Number of children who attended training.
  • Number of other programs that include Mister Germ in their program.
  • Increase in frequency of hand-washing among children and staff.
  • Teacher surveys.
  • Expansion of the program.

Development of the program

The North Coast has experienced ongoing outbreaks of communicable disease in children aged between 0-5. In 2006 the Public Health Unit (PHU) was asked to assist a preschool that had an outbreak of gastroenteritis. In addition Aboriginal Health requested assistance from the PHU following ongoing illness among local Aboriginal children. This identified a need for a hand-washing and hygiene program for young children.

A partnership was formed between the Public Health Unit, Aboriginal Health, Partnership for Aboriginal Care, Health Promotion and the Regional Health Service Program to establish a culturally appropriate hand washing program. The only hand-washing resource available in 2006 that was culturally appropriate for Aboriginal children was a primary school program called Mister Germ developed by the Tropical Public Health Unit in Cairns. Permission was granted for NSW Health to adopt this program and adapt it for local schools. It was decided the program would be adapted for preschools and delivered to primary schools on request.

The Mister Germ Program comprises:

  • A Manual Adapted and Developed by Robert Barnett from the Tropical Health Units Mister Germ Model.
  • A teacher's/presenter's activity guide that provides the preschool staff with a variety of physical, visual and verbal educational activities that show students what germs are, how they spread sickness and how this can be prevented. The duration of the activities is from 5 minutes to 20 minutes. The program is flexible and teachers may develop their own activities. Eungai Preschool developed a "micro-nasties" program that talked about germs and the importance of taking their medicines.

Additional components In the NSW program:

  • A nutrition component, developed by the Port Macquarie NCAHS Dietician Department. This resource is from the Department of Health and Human Services, Tasmania.
  • Regional Health Service Program, NCAHS, proper serving of food safety program, "Junga-Marlannggu Yuraal".
  • Partnership for Aboriginal Care, Deadly Tucker nutritional program.
  • Current information and facts sheets on immunisation schedules and communicable disease.

Resource Kits provide:

All the above materials and all the equipment to run the Mister Germ children's activities. Resource kits are rotated every three weeks between preschools within each local government area. Ownership of the kits lies with the participating preschools. The Public Health Unit's role is to maintain the resource kit and yearly preschool roster.

The kits contain many educational aids used to deliver the program activities including a UV light and box, toilet seat, 'Good/Bad Dog' picture cards, paint, model fruit, model breads, variety of posters, CD with program song, puppet fly and promotional products such as stickers, rulers and pencils. The program also features two costumes. One is the Mister Germ character (the bad character who spreads germs) and the newly established character 'The Germinator', the good character whose role is to wash Mister Germ away. The Germinator is an Aboriginal action hero and the colours of the character signify the Aboriginal and Torres Strait Islander Colours. The Germinator was suggested by Uncle Martin Ballangarry from the Gumbaynggirr Nation.


An initial pilot program was run in 2007 and involved 360 children from eight rural remote Aboriginal and Non-Aboriginal preschools across five council areas in the Mid North Coast.  Teacher training on how to run the program was conducted at each individual preschool. The training sessions were presented by Robert Barnett and Dianne Penberthy.

On completion, the pilot program was evaluated. Analysis showed the program to be an effective strategy in increasing the frequency of hand washing among children and their teachers. It also showed an increase in the knowledge around healthy hygiene and nutritional practices.

Analysis also showed that there was a high incidence of children sick. The Aboriginal preschools recorded a daily average 17.5% of children sick. In non-Aboriginal preschools the average daily number of sick children was 7.39%. The highest incidence of absentees in one day was 48.7% in one Aboriginal Preschool.

In 2008 the program was expanded and offered to preschools, family day care centres and vocational care centres in the Mid North Coast Preschools.  Six teacher training sessions of two-hours' duration were held across the five local council areas: Port Macquarie Hastings, Macleay, Nambucca, Bellingen and Coffs Harbour.

In 2009 on request from the North Coast Area Health Service (NCAHS) Director of the Public Health Unit, the Mister Germ Program was rolled out through five training sessions across five council areas: Casino, Kyogle Lismore, Byron and Ballina.


The table below shows the quantitative data from the 2008 program role out

Table 1.  Mid North Coast Training Results

  No. of schools  No. of attendees  Total children represented (x100)
Laurieton 4 10 4.15
Port Macquarie  7 13 7.09
Kempsey 8 13 6.23
Nambucca Heads 7 19 6.66
Bellingen 2 3 1.24
Coffs Harbour 5 6 8.76
Totals 33 64 34.13

The table below shows the quantitative data from the 2009 program role.

Table 2. Northern Rivers Training Results

Session Total schools  Total attendees Total children represented (x100)
Lismore (am) 7 11 3.93
Lismore (pm) 7 8 4.15
Casino (pm) 8 13 3.7
Ballina (am) 10 15 16
Ballina (pm) 3 4 2.15
Totals 35 51 29.93

Performance indicator results:

  • A total of 115 teachers have been trained.
  • A total of 78 Preschools have attended training.
  • A total of 10 local government areas involved.
  • A total of 78 Preschools have confirmed they will be introducing the program into their preschool.
  • A total of 6,000 Children in the preschool setting will have the opportunity to attend training.
  • Feed back for the frequency of hand-washing has been reported to have increased within both the school and home environment. Some preschools have reviewed their hand-washing policies and now have the children and staff washing hands on arrival.
  • The program has been expanded to other programs and Area Health Services as follows:
    • Croc Festival, Kempsey: 2006 and 2007 – 10,000 kids.
    • Shake a Leg Program, Currently run in twenty five Hunter New England and North Coast Area Health Service primary schools.
    • Animal Management in Rural Remote Indigenous Communities (AMIRRIC) dog health program. This is nationwide program, currently implementing the dog health component of the Mister Germ program in the Murdi Paaki region.
    • Greenhills Primary School. In August 2008 the school requested assistance from the NCAHS to assist with an outbreak of boils affecting 50 of its 54 pupils. Teachers were trained and the Mister Germ program was implanted at the school. Between February and May 2009 there has been only one reported case of boils at the school.

Impact of the program on the target group

Thousands of children in North Coast preschools and primary schools – and their families – now have the opportunity to participate in the first Indigenous children’s hand washing program in NSW. The program will provide local participating children with the whole of life skill of hand washing.

At the same time the schools they attend will be provided with the most up to date health information relevant to this target group. In addition the risk factors around food safety will be minimised under the Junga-Marlannggu Yuraal program and at the same time the children's awareness of healthy food alternatives will be increased.

The combination of food safety, good nutrition, increased frequency of hand washing practices and up to date health information for teachers and parents, should contribute to better health outcomes for the children and the broader community.


North Coast Area Health Service
Phone: 02 65882750


Date created: 17th Jun 2009 | Date reviewed: 8th Oct 2010